31st July 2023

A 19 year old student is referred to ambulatory care by their GP due to her blood results following a 1 week’s history of a sore throat, fever, and malaise.

A 19 year old student is referred to ambulatory care by their GP due to her blood results following a 1 week’s history of a sore throat, fever, and malaise. Significant blood results are as follows:

• ALT 174 (0-45 IU/L), ALP 40 (90-300 IU/L), AST 87 (0-50 IU/L), bilirubin 52 (3-20 µmol/).
• FBC is normal, and CRP is elevated to 88 mg/L.

On examination, there is tender cervical lymphadenopathy and mild tenderness at the left hypochondrium on her abdomen. Her eyes are tinged yellow.

She has no recent travel history. She is sexually active and uses barrier contraception.

Which of the following would you most likely find on further investigation?

Select the SINGLE most appropriate option from the list below. Select ONE option only.